12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule
hydrocodone bitartrate
RxCUI: 1860497
What the CMS Formulary Data Shows for 12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule
Per the CMS 2026 Part D formulary file, 12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule (RxNorm concept RXCUI 1860497, generic name hydrocodone bitartrate) appears on 7 distinct formulary files spanning 107 Medicare Part D plan offerings - 2.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.6.
Real-world access to 12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule depends on utilization management as much as tier placement: 28.6% of covering formularies require prior authorization. 0% require step therapy. 57.1% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule today.
Coverage Details
- Formularies covering
- 7
- Plans covering
- 107
- Coverage rate
- 2.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 28.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 57.1% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T4 | Yes | $0 | AZ |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T4 | Yes | $0 | AZ |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T4 | Yes | $0 | AZ |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T4 | Yes | $0 | AZ |
| Alignment Health My Choice (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health Platinum + Instacart (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health AllCare Preferred (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health Platinum + Instacart (HMO-POS) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health My Choice (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health Harmony (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health Balance (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health the ONE (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health CommUnity (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health smartSavings (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health My Choice Select (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health My Choice CalCare (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health Honor+ Plan (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health ValorCare (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health L.A. Premium Giveback (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health S.D. Premium Giveback (HMO) | ALIGNMENT HEALTH PLAN | T4 | Yes | $0 | CA |
| Alignment Health Platinum (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | Yes | $0 | NC |
| Alignment Health NC Duals (HMO-POS D-SNP) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | Yes | $0 | NC |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | Yes | $0 | NC |
| Alignment Health Platinum + Instacart (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | Yes | $0 | NV |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | Yes | $0 | NV |
| Alignment Health Platinum Select (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | Yes | $0 | NC |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T4 | Yes | $0 | NC |
| Alignment Health the ONE + Walgreens (HMO-POS) | ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC | T4 | Yes | $0 | TX |
Frequently Asked Questions
Is 12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule covered by Medicare Part D?
Yes, 12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule is covered by 107 Medicare Part D plans (2.1% of all Part D formularies).
What tier is 12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule on Medicare Part D plans?
12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule averages Tier 3.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does 12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule require prior authorization?
28.6% of Part D formularies require prior authorization for 12 HR hydrocodone bitartrate 30 MG Extended Release Oral Capsule. Step therapy: 0%. Quantity limits: 57.1%.
Read our methodology - how this data is sourced, computed, and verified.